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Clinical management and innovation in fracture non-union.
Siverino, C; Metsemakers, W-J; Sutter, R; Della Bella, E; Morgenstern, M; Barcik, J; Ernst, M; D'Este, M; Joeris, A; Chittò, M; Schwarzenberg, P; Stoddart, M; Vanvelk, N; Richards, G; Wehrle, E; Weisemann, F; Zeiter, S; Zalavras, C; Varga, P; Moriarty, T F.
Afiliación
  • Siverino C; AO Research Institute Davos, Davos Platz, Switzerland.
  • Metsemakers WJ; Department of Trauma Surgery, University Hospitals Leuven, Leuven, Belgium.
  • Sutter R; Department of Development and Regeneration, KU Leuven - University of Leuven, Leuven, Belgium.
  • Della Bella E; Radiology Department, Balgrist University Hospital, University of Zürich, Zürich, Switzerland.
  • Morgenstern M; AO Research Institute Davos, Davos Platz, Switzerland.
  • Barcik J; Center for Musculoskeletal Infections, Department of Orthopaedic and Trauma Surgery, University Hospital Basel, Basel, Switzerland.
  • Ernst M; AO Research Institute Davos, Davos Platz, Switzerland.
  • D'Este M; AO Research Institute Davos, Davos Platz, Switzerland.
  • Joeris A; AO Research Institute Davos, Davos Platz, Switzerland.
  • Chittò M; AO Innovation Translation Center, Davos Platz, Switzerland.
  • Schwarzenberg P; AO Research Institute Davos, Davos Platz, Switzerland.
  • Stoddart M; AO Research Institute Davos, Davos Platz, Switzerland.
  • Vanvelk N; AO Research Institute Davos, Davos Platz, Switzerland.
  • Richards G; Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.
  • Wehrle E; AO Research Institute Davos, Davos Platz, Switzerland.
  • Weisemann F; AO Research Institute Davos, Davos Platz, Switzerland.
  • Zeiter S; Institute for Biomechanics, ETH Zurich, Zurich, Switzerland.
  • Zalavras C; Department of Trauma Surgery, BG Unfallklinik Murnau, Murnau am Staffelsee, Germany.
  • Varga P; AO Research Institute Davos, Davos Platz, Switzerland.
  • Moriarty TF; Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Expert Opin Biol Ther ; 24(9): 973-991, 2024 Sep.
Article en En | MEDLINE | ID: mdl-39126182
ABSTRACT

INTRODUCTION:

With the introduction and continuous improvement in operative fracture fixation, even the most severe bone fractures can be treated with a high rate of successful healing. However, healing complications can occur and when healing fails over prolonged time, the outcome is termed a fracture non-union. Non-union is generally believed to develop due to inadequate fixation, underlying host-related factors, or infection. Despite the advancements in fracture fixation and infection management, there is still a clear need for earlier diagnosis, improved prediction of healing outcomes and innovation in the treatment of non-union. AREAS COVERED This review provides a detailed description of non-union from a clinical perspective, including the state of the art in diagnosis, treatment, and currently available biomaterials and orthobiologics.Subsequently, recent translational development from the biological, mechanical, and infection research fields are presented, including the latest in smart implants, osteoinductive materials, and in silico modeling. EXPERT OPINION The first challenge for future innovations is to refine and to identify new clinical factors for the proper definition, diagnosis, and treatment of non-union. However, integration of in vitro, in vivo, and in silico research will enable a comprehensive understanding of non-union causes and correlations, leading to the development of more effective treatments.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Curación de Fractura / Fracturas no Consolidadas Límite: Animals / Humans Idioma: En Revista: Expert Opin Biol Ther Asunto de la revista: BIOLOGIA / TERAPEUTICA Año: 2024 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Curación de Fractura / Fracturas no Consolidadas Límite: Animals / Humans Idioma: En Revista: Expert Opin Biol Ther Asunto de la revista: BIOLOGIA / TERAPEUTICA Año: 2024 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Reino Unido